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Why Is Outpatient Proton Therapy Less Expensive Than Hospital-Based Therapy?

Proton Therapy

Many patients aren’t aware that outpatient proton therapy is less expensive than hospital-based proton therapy. It’s not surprising. Medical care is not typically something patients price compare. Medical bills are not easy to understand to start with, and when you consider the added involvement of insurance providers, health care costs become a bit more convoluted and sometimes downright confusing. Most people simply try to choose a provider who is “in network” and whom their doctor recommends. There’s no such thing as “bargain hunting” for health care. Because of this, most patients don’t know that health care can have different costs depending on where you have it performed. That is exactly the case with proton therapy.

What Is Proton Therapy?

First, for anyone who doesn’t know what proton therapy is, here’s a brief summary:
Proton therapy is a newer kind of radiation treatment used to fight cancer. It has several advantages over the traditional photon (X-ray) therapy. Proton therapy delivers radiation which can target tumors much more precisely than traditional X-ray radiation, allowing physicians to deliver more powerful doses to the target with considerably less dose to surrounding healthy tissues. In some areas of the body, proton radiation offers better outcomes (tumor control and side effect profiles) than X-rays, particularly in areas such as the base of the skull, around the eyes, and when sensitive normal structures such as spinal cord and intestine are in the area which is being targeted. In many cases, both short term and long term side effects are diminished when protons are employed. In addition, because physicians can deliver higher doses of radiation to cancerous tumors, proton therapy may be able to yield higher cure rates.

Outpatient Proton Therapy Costs Less

Outpatient or office-based proton therapy is more affordable than hospital-based proton therapy. Why? Proton therapy is covered in the United States by Medicare and many insurance providers. But what you may not realize is that hospital-based radiation oncology programs are legally allowed, by insurance companies and Medicare, to charge higher rates and facility fees than privately owned facilities are allowed to charge. This is primarily because hospitals have much higher overhead costs (buildings, staffing, expenses) than outpatient clinics. As such, treatments delivered at outpatient clinics are often more cost effective. The fact that there is even a difference is simply not common knowledge among patients.

When Proton Therapy Is Not Covered by Insurance

This cost difference between outpatient and hospital treatment becomes even more important when proton therapy is not covered by insurance. Because it is a new type of treatment, the main reason for denial of coverage is because proton therapy is somewhat more expensive than other types of cancer treatments, making insurers less inclined to cover it when cheaper alternatives are available. When you consider you will be paying a percentage of your costs, this will affect how much you save out-of-pocket. Coverage varies by insurance company and disease type. If proton therapy is recommended, KCUC specialists work with each patient and their health insurance provider to determine the best option.

Kansas City’s Only Office-Based Proton Therapy Facility

You do have a choice when it comes to where you receive your proton therapy. At the Kansas City Proton Institute, our new proton therapy treatment center in Overland Park (due to open in winter of 2023), we offer the same level of care you would receive at a hospital-based setting for less. Besides savings, outpatient facilities like KCPI also offer a few advantages that a hospital can’t – particularly convenience. You will be in and out faster with much less hassle than at a typical big hospital setting. You don’t have to drive downtown, and you’ll have convenient parking in our parking garage. Navigating a smaller facility is easier and less stressful too. You can’t beat the combination of increased convenience and lower costs at Kansas City Proton Institute. At KCPI, we are cutting costs on cutting-edge care.

KCPI will be the only office-based radiation facility in the central United States. We are proud to be able to offer this new type of cancer treatment at a lower cost. If you would like to learn more about proton therapy, visit our website at www.kcuc.com and schedule an appointment to speak with a urologist or oncologist. Kansas City Urology and Oncology has multiple locations across the Kansas City Metro area so we’re never far from home. At KCUC, you see the best in KC.